Provider Demographics
NPI:1821069188
Name:COMPLETE HOME CARE INC.
Entity Type:Organization
Organization Name:COMPLETE HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:LARRY
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-862-7828
Mailing Address - Street 1:709 S ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MS
Mailing Address - Zip Code:38843-4404
Mailing Address - Country:US
Mailing Address - Phone:662-862-7828
Mailing Address - Fax:662-862-7294
Practice Address - Street 1:709 S ADAMS ST
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MS
Practice Address - Zip Code:38843-4404
Practice Address - Country:US
Practice Address - Phone:662-862-7828
Practice Address - Fax:662-862-7294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00040212Medicaid
MS0187420001Medicare ID - Type UnspecifiedPROVIDER NUMBER